必要性、正当性、知情同意兼顾的患者利益最佳:一例男性性腺发育不良患儿诊治的伦理视角  

The Best Interests of Patients with Necessity,Legitimacy and Informed Consent:Ethical Perspectives on the Diagnosis and Treatment of a Case of Male Gonadal Dysplasia

作　　者：施敏[1] 李劲松[1] 黄琦程 陈周彤 邱文娟[1] 夏卫萍[1] 童剑云 SHI Min;LI Jinsong;HUANG Qicheng;CHEN Zhoutong;QIU Wenjuan;XIA Weiping;TONG Jianyun(Medical Ethics Committee,Xinhua Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200092,China;Shanghai Kangzheng Law Firm,Shanghai 200080,China)

机构地区：[1]上海交通大学医学院附属新华医院医学伦理委员会,上海200092 [2]上海市康正律师事务所,上海200080

出　　处：《中国医学伦理学》2021年第9期1198-1202,共5页Chinese Medical Ethics

摘　　要：性腺发育不良以及相关的性别选择与决定问题涉及遗传、解剖、生理、心理和社会学等诸多方面,同时会引发一系列伦理问题。结合一例罕见的男性性腺发育不良、17β-羟类固醇脱氢酶缺陷症3型患儿手术治疗的伦理讨论案例,从医学伦理学角度进行多维度的分析与探讨,得出如下结论:性别的选择是性腺发育不良治疗的关键,治疗应在充分沟通和考虑患者及其监护人的意愿后尽早进行,应始终把患者的利益放在首位。伦理考虑的要点在于:遵循必要性、正当性原则、知情同意原则兼顾患儿利益最佳原则。Gonadal dysplasia and related issues of sex selection and decision involve many aspects such as heredity,anatomy,physiology,psychology and sociology,as well as caused a series of ethical issues.Combining with a rare case of ethical discussion on surgical treatment of male gonadal dysplasia and 17β-hydroxysteroid dehydrogenase deficiency type 3,this paper made a multi-dimensional analysis and discussion from the perspective of medical ethics,and drew the following conclusions:gender selection is the key of gonadal dysplasia treatment.The treatment should be carried out as soon as possible after full communicating and consideration of the wishes of the patient and his or her guardian.The interests of patients should always be put in the first place.Ethics Committee should follow the principles of necessity,legitimacy,informed consent and best interests of patients while reviewing.

关 键 词：性腺发育不良 伦理原则 患者利益最佳 

分 类 号：R-052[医药卫生]